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Chimeric antigen receptor T cell (CAR-T) therapy, as a disruptive innovative therapy, is booming in China
.
On June 22, 2021, Yikaida® (Akilunza injection) was formally approved by the National Medical Products Administration (NMPA), becoming China’s first CAR-T therapy drug targeting CD19 for the treatment of previously accepted drugs Adult patients with relapsed or refractory large B-cell lymphoma (R/R LBCL) after second-line or above systemic treatment have brought new treatment options for R/R LBCL
.
At present, it has been approved in 38 countries around the world, and has accumulated nearly 5,000 patient experience
.
In order to promote the development of China's CAR-T field, build China's CAR-T star treatment center, and cooperate with international and domestic diagnosis and treatment
.
"CCSC (China CAR-T Star Center)-Kylinhui International Connection" continues! September 28, 2021-The new phase of Kylin Club International Connection was successfully held in Beijing
.
This conference is fortunate to invite Professor Song Yuqin from Peking University Cancer Hospital, Professor Sattva Neelapu from MD Anderson Cancer Center and many top domestic experts as speakers and discussion guests, focusing on cutting-edge topics in the field of CAR-T cell therapy.
-T cell therapy drug Yikaida® (Akilunza injection) for in-depth discussions and exchanges
.
Below, I will take you to review the wonderful links of this conference.
I hope that this conference can expand clinicians' understanding of the clinical efficacy of Akirensai injection and further improve the clinical benefits of patients
.
Looking at the clinical application of CAR-T in lymphoma from an international perspective.
In this session, Professor Sattva S.
Neelapu from MD Anderson Cancer Center gave a speech entitled "Clinical application of CAR-T in DLBCL: International perspective"
.
Professor Sattva S.
Neelapu started from the ZUMA-1 study, combined 2 patient cases, analyzed in detail the factors affecting the efficacy and toxicity of CAR-T, and added points to the precautions before and after CAR-T treatment
.
He pointed out that the efficacy and toxicity of CAR-T are affected by multiple factors, mainly from three aspects, the patient's own status, tumor condition and CAR-T treatment-related factors
.
From the perspective of patients, the patient’s age, clinical manifestations, whether there are complications, inflammatory status, immune function, previous treatments and microbial conditions are all related factors; from the perspective of tumors, tumor burden, tumor subtypes, The density of the antigen or the presence or absence of loss and the microenvironment have an impact; from the perspective of CAR-T treatment, the dose, composition, phenotype, signal domain, etc.
will all affect the efficacy and toxicity of the treatment
.
Therefore, before treatment, attention should be paid to the management of tumor burden, the control of inflammation, the control of treatment time, and the adjustment of diet; after treatment, attention should be paid to the management of adverse reactions, the use of glucocorticoids and immunosuppressants.
Regulation
.
Chinese and foreign thinking collided with CAR-T treatment.
The experts participated in the discussion on the sharing of Professor Sattva S.
Neelapu
.
Professor Ying Zhitao from Peking University Cancer Hospital raised questions about the combined use of CAR-T therapy and transplantation, the disease progression of patients after treatment, and the dose reduction of the conditioning plan
.
Professor Sattva S.
Neelapu believes that the efficacy of the combination of CAR-T therapy and transplantation is still inconclusive.
Although there are currently good results in China, some foreign studies may even come to the opposite conclusion, which may be related to patients.
The MRD status and the choice of CAR-T drugs are related; although there are still patients with disease progression after CAR-T treatment, and even myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML), it is similar to no treatment.
The incidence rate has been greatly reduced; the dose reduction of the conditioning regimen is based on toxicity considerations.
The toxicity brought by high-dose treatment has exceeded the therapeutic benefit, so low doses are selected to control toxicity
.
Professor Xiangyu Zhao from the Institute of Hematology, Peking University raised questions about the use of glucocorticoids before CAR-T treatment and the impact of hemophagocytic lymphohistiocytosis (HLH) after CAR-T treatment
.
Professor Sattva S.
Neelapu believes that the current study shows that the use of glucocorticoids has no significant impact on the survival of patients, but in the ZUMA study, cohort 4 and cohort 6 showed that glucocorticoids can reduce grade 3-4 adverse reactions and The role of tumor burden, so it is too early to make a conclusion, and further research is needed; the cause of HLH is not clear, and may be related to the patient’s previous infection, but this is only the result of observation from some cases.
As for the treatment of HLH, there are still certain challenges, and we need to continue to work hard
.
Professor Feng Feier from Peking University Cancer Hospital raised questions about the patient's vaccination and the order of different treatments
.
Professor Sattva S.
Neelapu believes that CAR-T treatment will delay the patient’s immune response, so it is recommended that the patient be vaccinated after 3 months of treatment, and the number of B cells in the patient will be tested at the same time, in order to give the vaccine in the best blood state of the patient; CAR-T therapy is currently mostly used in second-line and above in the United States, and Professor Sattva S.
Neelapu supports CAR-T for front-line therapy, hoping to have more evidence to support it to make changes
.
Professor Song Yuqin finally raised questions about the definition of whether the patient is cured
.
Professor Sattva S.
Neelapu believes that the recurrence after treatment mostly occurs within 6 months, and the recurrence rate of survival reaching 6 months, 1 year or even 2 years will continue to decrease
.
In the research center where Professor Sattva S.
Neelapu is located, no recurrence has been found for patients who have survived for more than 18 months
.
But when should a cure be defined, more evidence is needed
.
Summary At the end, Professor Song Yuqin made a summary of the meeting
.
Professor Song thanked Fosun Kate for the invitation and thanked Professor Sattva S.
Neelapu for sharing his experience
.
I believe that with the continuous in-depth research of CAR-T therapy, CAR-T treatment plan will be more perfect, and ultimately change the treatment ecology in the field of lymphoma and hematology, and achieve long-term and good survival benefits for patients! Poke "read the original text", we make progress together
.
On June 22, 2021, Yikaida® (Akilunza injection) was formally approved by the National Medical Products Administration (NMPA), becoming China’s first CAR-T therapy drug targeting CD19 for the treatment of previously accepted drugs Adult patients with relapsed or refractory large B-cell lymphoma (R/R LBCL) after second-line or above systemic treatment have brought new treatment options for R/R LBCL
.
At present, it has been approved in 38 countries around the world, and has accumulated nearly 5,000 patient experience
.
In order to promote the development of China's CAR-T field, build China's CAR-T star treatment center, and cooperate with international and domestic diagnosis and treatment
.
"CCSC (China CAR-T Star Center)-Kylinhui International Connection" continues! September 28, 2021-The new phase of Kylin Club International Connection was successfully held in Beijing
.
This conference is fortunate to invite Professor Song Yuqin from Peking University Cancer Hospital, Professor Sattva Neelapu from MD Anderson Cancer Center and many top domestic experts as speakers and discussion guests, focusing on cutting-edge topics in the field of CAR-T cell therapy.
-T cell therapy drug Yikaida® (Akilunza injection) for in-depth discussions and exchanges
.
Below, I will take you to review the wonderful links of this conference.
I hope that this conference can expand clinicians' understanding of the clinical efficacy of Akirensai injection and further improve the clinical benefits of patients
.
Looking at the clinical application of CAR-T in lymphoma from an international perspective.
In this session, Professor Sattva S.
Neelapu from MD Anderson Cancer Center gave a speech entitled "Clinical application of CAR-T in DLBCL: International perspective"
.
Professor Sattva S.
Neelapu started from the ZUMA-1 study, combined 2 patient cases, analyzed in detail the factors affecting the efficacy and toxicity of CAR-T, and added points to the precautions before and after CAR-T treatment
.
He pointed out that the efficacy and toxicity of CAR-T are affected by multiple factors, mainly from three aspects, the patient's own status, tumor condition and CAR-T treatment-related factors
.
From the perspective of patients, the patient’s age, clinical manifestations, whether there are complications, inflammatory status, immune function, previous treatments and microbial conditions are all related factors; from the perspective of tumors, tumor burden, tumor subtypes, The density of the antigen or the presence or absence of loss and the microenvironment have an impact; from the perspective of CAR-T treatment, the dose, composition, phenotype, signal domain, etc.
will all affect the efficacy and toxicity of the treatment
.
Therefore, before treatment, attention should be paid to the management of tumor burden, the control of inflammation, the control of treatment time, and the adjustment of diet; after treatment, attention should be paid to the management of adverse reactions, the use of glucocorticoids and immunosuppressants.
Regulation
.
Chinese and foreign thinking collided with CAR-T treatment.
The experts participated in the discussion on the sharing of Professor Sattva S.
Neelapu
.
Professor Ying Zhitao from Peking University Cancer Hospital raised questions about the combined use of CAR-T therapy and transplantation, the disease progression of patients after treatment, and the dose reduction of the conditioning plan
.
Professor Sattva S.
Neelapu believes that the efficacy of the combination of CAR-T therapy and transplantation is still inconclusive.
Although there are currently good results in China, some foreign studies may even come to the opposite conclusion, which may be related to patients.
The MRD status and the choice of CAR-T drugs are related; although there are still patients with disease progression after CAR-T treatment, and even myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML), it is similar to no treatment.
The incidence rate has been greatly reduced; the dose reduction of the conditioning regimen is based on toxicity considerations.
The toxicity brought by high-dose treatment has exceeded the therapeutic benefit, so low doses are selected to control toxicity
.
Professor Xiangyu Zhao from the Institute of Hematology, Peking University raised questions about the use of glucocorticoids before CAR-T treatment and the impact of hemophagocytic lymphohistiocytosis (HLH) after CAR-T treatment
.
Professor Sattva S.
Neelapu believes that the current study shows that the use of glucocorticoids has no significant impact on the survival of patients, but in the ZUMA study, cohort 4 and cohort 6 showed that glucocorticoids can reduce grade 3-4 adverse reactions and The role of tumor burden, so it is too early to make a conclusion, and further research is needed; the cause of HLH is not clear, and may be related to the patient’s previous infection, but this is only the result of observation from some cases.
As for the treatment of HLH, there are still certain challenges, and we need to continue to work hard
.
Professor Feng Feier from Peking University Cancer Hospital raised questions about the patient's vaccination and the order of different treatments
.
Professor Sattva S.
Neelapu believes that CAR-T treatment will delay the patient’s immune response, so it is recommended that the patient be vaccinated after 3 months of treatment, and the number of B cells in the patient will be tested at the same time, in order to give the vaccine in the best blood state of the patient; CAR-T therapy is currently mostly used in second-line and above in the United States, and Professor Sattva S.
Neelapu supports CAR-T for front-line therapy, hoping to have more evidence to support it to make changes
.
Professor Song Yuqin finally raised questions about the definition of whether the patient is cured
.
Professor Sattva S.
Neelapu believes that the recurrence after treatment mostly occurs within 6 months, and the recurrence rate of survival reaching 6 months, 1 year or even 2 years will continue to decrease
.
In the research center where Professor Sattva S.
Neelapu is located, no recurrence has been found for patients who have survived for more than 18 months
.
But when should a cure be defined, more evidence is needed
.
Summary At the end, Professor Song Yuqin made a summary of the meeting
.
Professor Song thanked Fosun Kate for the invitation and thanked Professor Sattva S.
Neelapu for sharing his experience
.
I believe that with the continuous in-depth research of CAR-T therapy, CAR-T treatment plan will be more perfect, and ultimately change the treatment ecology in the field of lymphoma and hematology, and achieve long-term and good survival benefits for patients! Poke "read the original text", we make progress together
